Care Management Nurse (RN)

Job Summary Join our dynamic team where you will play a critical role in providing essential support for care management and coordination of long-term services and supports (LTSS). As a Care Management Nurse, you will collaborate with a multidisciplinary team to ensure integrated delivery of care for members with high-need potential. Your contributions will help drive member progress toward desired health outcomes while promoting quality and cost-effective member care. Essential Job Duties Conduct comprehensive member assessments within regulated timelines, including in-person home visits as necessary. Facilitate waiver enrollment and disenrollment processes effectively. Collaborate with members, caregivers, and healthcare professionals to develop and implement personalized care plans. Monitor care plans continuously to evaluate effectiveness and recommend adjustments as needed. Promote integration of services, including behavioral health care and LTSS, to enhance continuity of care for members. Assess medical necessity and authorize appropriate waiver services. Evaluate covered benefits and provide guidance regarding funding sources. Lead interdisciplinary care team (ICT) meetings to approve or deny services. Utilize motivational interviewing techniques to support and inspire members during interactions. Identify barriers to care and provide resources to help address psycho/social, financial, and medical obstacles. Develop prevention plans for critical incidents to ensure member health and safety. Provide consultation and support to peers as needed. Your responsibilities may include managing complex member cases and conducting medication reconciliations as required. Local travel of 25-40% may be needed based on state and contractual requirements. Required Qualifications Minimum of 2 years of healthcare experience, with at least 1 year in care management or a related medical/behavioral health setting, and 1 year working with individuals with disabilities, chronic conditions, or substance abuse disorders. Current, active, and unrestricted Registered Nurse (RN) license in the state of practice. Valid driver's license, reliable transportation, and adequate auto insurance for work-related travel. Detail-oriented, proactive, and able to operate independently with minimal supervision. Excellent communication skills, both verbal and written. Proficient in Microsoft Office Suite and applicable software programs. Preferred Qualifications Certified Case Manager (CCM) certification. Experience with populations receiving waiver services. Take advantage of this opportunity to make a real difference in the lives of the members you serve. We offer a competitive benefits and compensation package. Join us at Molina Healthcare, an Equal Opportunity Employer. Pay Range: $26.41 - $51.49 / HOURLY Actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.

Created: 2026-03-04